Amend 03 Exhibit Q- Form CRT-61 Certificate of Resale.pdf

CRT-61 (R-04/25)

Illinois Department of Revenue

CRT-61 Certificate of Resale (Sales and Related Taxes, Fees, and E911 Surcharge) A Certificate of Resale is a statement signed by the purchaser that indicates the merchandise purchased is for resale purposes only. Note: It is the seller’s responsibility to verify that the purchaser’s retailer or reseller Illinois account ID number is valid and active. You can confirm this by using the Verify a Registered Business link at mytax.illinois.gov. This system allows you to inquire whether a business is registered with the Illinois Department of Revenue (IDOR) and how that business is registered.

Step 1: Identify the seller Name

Address

City State ZIP

Step 2: Identify the purchaser Name

Address

City State ZIP

Complete the information below. Check only one box.

The purchaser is registered as a retailer or reseller with IDOR. Account ID number __ __ __ __ - __ __ __ __ .

The purchaser is an out-of-State purchaser authorized to do business out-of-State and not required to be registered as a retailer or reseller in Illinois and will resell and deliver this property only to purchasers located outside the State of Illinois. Enter the other state name and account/registration number: __________________________ (or attach copy of registration to Form CRT-61). See instructions.

If making a blanket certificate, skip to Step 4 or 5.

Step 3: Describe the property Describe the property that is being purchased for resale or list the invoice number and the date of purchase.

For a blanket certificate to qualify, the purchaser must complete Step 4 or 5. See instructions for more information.

Step 4: Complete for full blanket certificates

I am the identified purchaser, and I certify that all of the purchases that I make from this seller are for resale.

Step 5: Complete for percentage blanket certificates I am the identified purchaser, and I certify that the following percentage, ______ %, of all of the purchases that I make from this seller are for resale. List the item: _______________________________________________________________

Note: This is for use only with single item type purchases, such as cooking oil used in preparing foods. See instructions.

Step 6: Purchaser’s signature I certify that I am purchasing the property in Step 3, Step 4, or Step 5 from the stated seller for the purpose of resale. I understand that if I use the item(s) purchased under this certificate in any manner other than as just described, I will owe tax based on each item’s purchase price or as otherwise provided by law.

I understand misuse or misrepresentation may also result in penalties, interest, and criminal prosecution.

Purchaser’s signature Email address Date

Printed by the authority of the State of Illinois - Electronic only, one copy

Fermi Forward Discovery Group, LLC

Kirk Rd. and Pine St.

Batavia IL 60510

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